Provider Demographics
NPI:1750717021
Name:GEORGE, MELISSA G (CLD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:G
Last Name:GEORGE
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 NW VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-1818
Mailing Address - Country:US
Mailing Address - Phone:913-579-5637
Mailing Address - Fax:
Practice Address - Street 1:501 NW VILLAGE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-1818
Practice Address - Country:US
Practice Address - Phone:913-579-5637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula